Treatments for Venous Disease

The Vascular Surgeons at Mid-Atlantic Surgical Group care for all forms of disease of the veins. Patients with vein disease may suffer from varicose veins, DVT, venous ulceration, May-Thurner Syndrome, or often a combination of these problems.

Our doctors are committed to guiding patients with venous disease through an algorithmic approach to their care. We believe that experienced Vascular Surgeons are able to provide the most effective, least invasive, and most durable treatments for venous disease.

Varicose Vein Care

Varicose Veins are the most common vascular condition overall – 80% or more of us have varicose veins. While for many of us these are not a significant issue, there are many patients who find that their varicose veins cause disfigurement, aching, pain, leg swelling, leg discoloration, or even ulceration. When varicose veins are a problem, there is no better specialist to seek out for treatment than a Vascular Surgeon. At Mid-Atlantic Surgical Group, our Vascular Surgeons are committed to finding an appropriate treatment plan for each patient – tailored to the patient’s specific goals and symptoms.

Most varicose veins are the result of venous reflux disease – the leaking of valves within the veins that causes dark venous blood to pool in the veins of the legs. This causes the veins to bulge, ache, itch, and spread over time.

Venous reflux mostly occurs in the superficial veins, which are close to the skin. These veins can be closed down using endovenous laser therapy. This treatment is performed in our office in less than an hour, and can reduce or eliminate varicose veins.

For patients who are not candidates for endovenous laser therapy, other treatments are available. Many spider veins and some larger veins can be treated with sclerotherapy. This simple, in-office procedure uses a sclerosant – a medication which causes veins to scar closed – to close down unwanted or painful varicose veins. Sclerotherapy is performed by simple injections in the office, sometimes over several sessions depending on the extent of the varicose veins.

Endovenous Laser Therapy

Most patients with varicose vein disease will be found to have significant reflux, or leaking valves, in one or both of their saphenous veins. The Greater Saphenous Vein (GSV) is located on the inner surface of the leg, coursing from the groin to the ankle. The Lesser Saphenous Vein (LSV) is located on the posterior (back) surface of the lower leg, extending from the knee crease to the outer surface of the ankle.

When the GSV or the LSV is found to be the cause of varicose veins or venous ulceration, closure of these veins can treat a patient’s symptoms. Endovenous Laser Therapy (EVLT) is a minimally invasive technique that uses laser energy to damage the inner surface of the saphenous vein, causing it to scar close in the days after the procedure. EVLT is performed in Mid-Atlantic Surgical Group’s office, often in less than 30 minutes.

In our office procedure room, after applying local anesthetic, the laser catheter is inserted into the saphenous vein under ultrasound guidance.

The catheter is then guided to the beginning of the diseased vein. Once the laser is properly positioned, dilute local anesthetic is placed around the vein for comfort and to compress the vein around the laser catheter. After this tumescent anesthesia is instilled, the laser is turned on and the catheter is slowly withdrawn, allowing the laser energy to affect the entire length of the leaking saphenous vein.

Once the procedure is completed, the patient’s leg is compressed with a fitted compression stocking that will be kept on for 7 days. This period of compression allows the injured saphenous vein to scar closed. Patients frequently can resume work within 1-2 days after the procedure with minimal discomfort. Walking activity and mobility are encouraged immediately after the procedure is completed.

Deep Vein Thrombosis (DVT) Care

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IVC Filter Placement and Removal

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May-Thurner’s Disease Care

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Venous Ulcer Care

Caring for the patient with a venous ulcer requires a thorough evaluation in order to identify the cause or causes of the ulcer. Many patients with venous ulcer suffer from a combination of both venous reflux disease and venous obstructive disease. By identifying the underlying causes of the patient’s wound, a stepwise approach can be formulated to best treat the ulcer and prevent a new one from forming.

The Vascular Surgeons at Mid-Atlantic Surgical Group carefully assess venous ulcer patients to identify the underlying causes that require treatment. Our doctors work closely with each patient’s wound care team to speed recovery and prevent recurrence.

Many patients with venous ulceration are often found to have venous reflux which can be treated with endovenous laser therapy – a quick, in-office procedure that can eliminate or reduce venous reflux and rapidly allow a wound to heal.

Patients with venous obstructive disease are often candidates for venous stenting or venous thrombectomy. These procedures can restore normal flow in a vein that previously was impeded, reducing the pressure that causes venous ulcers to form.

For more information or to schedule a consultation, please call us at: (410) 543-9332

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